Lateral Epicondyle Tendinopathy Toolkit: Section H - Braces, Splints, and Taping: Difference between revisions

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== Supporting Evidence ==
There is differing evidence to support the use of orthotic devices and taping to treat LET. The evidence is summarised below; for more information, please see [[Lateral Epicondyle Tendinopathy Toolkit: Section D - Summary of the Evidence|Section D - Summary of the Evidence for Physical Therapy Interventions]].
'''Orthotic devices'''
* Acute Stage: There is weak evidence that orthotic devices (brace, sleeve or splint) may reduce immediate pain compared to placebo. There is weak evidence that a counterforce brace may reduce pain in the short term (<6 weeks).
* Chronic Stage: Weak evidence for effectiveness of US in the management of chronic LET.  1 MHz or 3 MHz, 1.0 – 2.0 W/cm2 5-12 minutes. The total number of treatments used in many of the studies is greater than might be economically viable in real-world therapeutic settings (many studies used more than 10 sessions).
'''Taping'''
* Acute Stage: Expert opinion exists to suggest that the use of taping for patients with acute LET may support immediate pain relief and  an increase in grip strength.
* Chronic Stage: Two placebo controlled trials, and two experimental studies have demonstrated efficacy of taping for providing immediate pain relief. Taping has not been consistently shown to benefit strength. Studies have often been conducted alongside an exercise intervention.


== Resources ==
== Resources ==

Revision as of 19:06, 8 November 2022

Original Editor - Vidya Acharya for BC Physical Therapy Tendinopathy Task Force:

Dr. Joseph Anthony, Paul Blazey, Dr. Allison Ezzat, Dr. Angela Fearon, Diana Hughes, Carol Kennedy, Dr. Alex Scott, Michael Yates and Alison Hoens

Top Contributors - Vidya Acharya, Kim Jackson, Evan Thomas, Admin, Wanda van Niekerk, Rishika Babburu and 127.0.0.1




Introduction[edit | edit source]

Various methods have been developed to treat lateral epicondyle tendinopathy that includes brace, splints and taping. It has been found that splinting, bracing, and taping are useful interventions for protecting, stabilising, or immobilising injured or inflamed areas.

Counterforce Brace[edit | edit source]

A counterforce brace is one of the most conventional treatments. The mechanism of action for this brace is the transferring of stress from the wounded tissue to the unaffected tissues around it. A combined cadaveric and clinical study[1] showed a 13-15% force reduction of the Extensor Carpi Radialis Brevis origin with the counterforce brace.

  • They are often used for pain relief.
  • They are thought to diffuse the load through the tendon to less sensitive areas, thereby decreasing the stress on the area of pathology.
Counterforce Badge




Wrist Splint[edit | edit source]

Wrist splints reduces tension and load at the extensor origin, thus promoting tendon repair.

  • Wrist splints are less commonly used in the Lateral Epicondyle Tendinopathy.
  • But they do have some support for temporary pain relief in more acute patients.
  • The goal is to rest the musculotendinous unit originating at the lateral epicondyle.
Wrist splint


Diamond Taping Technique[edit | edit source]

Taping provides support and stability for the preventing injury as well as it protects the injured anatomical structure during healing.

  • The goal is to decrease tension at the epicondyle attachment.
  • Diamond Taping Technique [2]consists of four tape strips, repeated twice.
  • The tape is laid in a diamond shape while pulling the soft tissues centrally towards the lateral epicondyle.
Diamond taping technique


Supporting Evidence[edit | edit source]

There is differing evidence to support the use of orthotic devices and taping to treat LET. The evidence is summarised below; for more information, please see Section D - Summary of the Evidence for Physical Therapy Interventions.

Orthotic devices

  • Acute Stage: There is weak evidence that orthotic devices (brace, sleeve or splint) may reduce immediate pain compared to placebo. There is weak evidence that a counterforce brace may reduce pain in the short term (<6 weeks).
  • Chronic Stage: Weak evidence for effectiveness of US in the management of chronic LET. 1 MHz or 3 MHz, 1.0 – 2.0 W/cm2 5-12 minutes. The total number of treatments used in many of the studies is greater than might be economically viable in real-world therapeutic settings (many studies used more than 10 sessions).

Taping

  • Acute Stage: Expert opinion exists to suggest that the use of taping for patients with acute LET may support immediate pain relief and an increase in grip strength.
  • Chronic Stage: Two placebo controlled trials, and two experimental studies have demonstrated efficacy of taping for providing immediate pain relief. Taping has not been consistently shown to benefit strength. Studies have often been conducted alongside an exercise intervention.

Resources[edit | edit source]

References[edit | edit source]

  1. ↑ Meyer NJ, Walter F, Haines B, Orton D, Daley RA. Modeled evidence of force reduction at the extensor carpi radialis brevis origin with the forearm support band. The Journal of hand surgery. 2003 Mar 1;28(2):279-87.
  2. ↑ Vicenzino B, Brooksbank J, Minto J, Offord S, Paungmali A. Initial effects of elbow taping on pain-free grip strength and pressure pain threshold. Journal of Orthopaedic & Sports Physical Therapy. Jul 2003; 33(7): 400-7.
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